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Honestly, I can't wait for deep learning and computational methods to dethrone doctors and upend the medical profession. In the next five years, expect a comput

Honestly, I can't wait for deep learning and computational methods to dethrone doctors and upend the medical profession. In the next five years, expect a computer to be able to predict most diseases a lot better than doctors can -- and with none of the attitude, high cost, or inconvenience. Mind you I'm not talking about researchers, who will always have a job. I'm talking about practitioners. I've had a medical condition from birth and I've had to deal with my share of doctors. Outside of the insurance system, they are easily the most unpleasant part of the whole ordeal to deal with. There are some gems, but most you will encounter are pompous, arrogant, and "commanding" -- when they enter a room, they are flanked by "residents", "assistants" and generally give off this air of superiority which is really just because of their route experience. The whole thing comes off more as a performance than anything else. Worse, they often get mad when you question them or ask them to explain themselves, or how they arrived at a conclusion. Good luck finding work when an algorithm can do your job better than you. It's only a matter of time.

doesnotexist 10y ago
Not so sure we are going to see an automation completely replace doctors. Just look at all the problems both technical as well as social in the self-driving cars arena. There lot more people are qualified to be drivers than to practice medicine. Instead, I think we'll see more powerful diagnostic tools at the disposal for physicians to use. Doctors will still play an important role in treating their patients and will be more effective because they'll have powerful tools assisting them. But to your point, will technology help patients feel more empowered in their medical encounters? Or to get more value out of their interactions with their doctors? https://www.remedymedical.com/ https://www.remedymedical.com/ seems to think their platform will do just that for primary care / telemedicine visits.
- dave_sullivan 10y ago
  > Doctors will still play an important role in treating their patients and will be more effective because they'll have powerful tools assisting them. I get into this argument with people a lot. I say something like, "Self driving cars will replace all the transport jobs" and the pedant says, "Well they won't replace ALL the transport jobs, so argument null and void." But no shit they won't replace ALL the transport jobs, if they replace even 30% of them, that's huge. Highest unemployment during "The Great Depression" was ~25%. I think in the case of transportation it will be more like 80% fewer transportation jobs in 10 years, something like that. With doctors and hospitals, if there were better incentives in place promoting any level of efficiency, we would have less need for doctors (and hospital staff in general). I agree that we won't see 100% automation. But a hospital finding it can do more and better work with 50% less staff? I could see that being a possibility in our near future, with the caveat that it won't happen in the US due to the regulatory environment and incentives in healthcare. Countries outside of the US might be more open to the idea of efficiency in healthcare.
  - doesnotexist 10y ago
    Thought experiment: do you think some part of your job will be automated before or after hospitals automate away 50% of their medical staff?
    - dave_sullivan 10y ago
      Depends on which job: Programming, machine learning: it's constantly being automated, which leads to paradigm shifts. Those new paradigms are then studied, understood, and automated. Automation is about "not doing the same thing over and over again so you can solve new problems." Programming, games: I'm giving a talk later this month about automating game production with machine learning. You can't really use machine learning to be "creative" yet, but you can use it to generate novel game assets, which is actually where most of the time is spent in game dev. There's also a lot of pipeline improvements that could be made by existing tools companies, most notably Adobe and Autodesk. So the upshot is it will be possible for small teams to create much more expansive game worlds. Make GTA V for $1M instead of $260M kind of thing. But even then, the history of game design has been automating different pieces -- it's basically the reason for the existence of game engines. Starting businesses: This is controversial, but I think entrepreneurship is the highest intellectual endeavor. It requires you to apply everything you've learned about life, the universe, and everything in ways that most people haven't thought of. I think you'd need a very real AGI to do this; although I suppose I could see an algo running P&G or J&J and making decisions about what brands to invest in and divest from, along with how to market based on what people are saying on social media, stuff like that.
  - whyileft 10y ago
    It is no different than going to the urgent care clinic for a strep test. Doctors do not perform those either. Most diagnosis will be done via software administered by lower paid and more easily replaceable low skill labor just like urgent care clinics do with lab testing. There are fewer accountants today because of tax software and Excel spreadsheets. They are still needed for more complex and unique situations, but there will be a lot fewer of them. The local H&R Block uses lower paid "Tax Preparers" instead. There are a lot of research done about Walmart and about when the store moved into town there were not fewer jobs, but somehow the area got poorer. What they found was that the local community leaders(small business owners, lawyers, accountants) were automated away and/or moved to Walmart headquarters. http://aese.psu.edu/nercrd/economic-development/for-researchers/poverty-issues/big-boxes/wal-mart-and-poverty/article-wal-mart-and-county-wide-poverty http://aese.psu.edu/nercrd/economic-development/for-research... Is one I could find, but that also references other papers in the field. This leads to me understand that like Walmart, the simple human physical labor jobs will remain long after the more skilled positions. The main reason, I believe, is that software is simply cheaper than hardware(robots) so highly skilled positions which require software not hardware to remove will be the first to go. This is exacerbated by the fact that the software replaceable jobs are the highest paid and therefore the most profitable to remove.
- bluGill 10y ago
  I think it will be both. They will start with software for doctors - who will use it because the computer never forgets to ask some critical question that could discover a 1 in a million disease and not the common cold (with similar symptoms) that the everyone else in the office today has. Eventually urgent cares and ER will install them for people directly. No reason the machine can't prescribe antibiotics for the latest form of strep that is going around. That leaves the doctor for the hard cases where the machine doesn't know.
komali2 10y ago
I never thought doctors would be hit so soon by the automation/AI crisis, but this article challenges that thought. However, due to the state of robotics at the moment, surgeons for example aren't going anywhere for a good decade I'd estimate, and it's not like people can, in the mole example, self-remove a chunk of it for biopsy with 99% accuracy. Then there's treatment that has to be done at a hospital under monitor of professionals, etc.
- _delirium 10y ago
  > I never thought doctors would be hit so soon by the automation/AI crisis I think most people in AI are more surprised that it took this long. The tech has been there for decades for a pretty large percentage of routine diagnostics, especially carefully defined clinical-sample type diagnostics. People were pretty sure in the '80s that it'd all be automated soon, but it never managed to make it into actual hospitals so funding dried up. Mixture of bureaucracy, legal issues, patients not liking the idea of computer diagnosis, doctors not liking the idea of computer diagnosis, incentives, etc. I think changes in all those "environmental" factors are likely to be the biggest boost to something like this getting deployed in practice. Tech advances are good as well, and will expand the range of diagnostics that can be automated, but there is already enough low-hanging fruit in medicine that is easy enough for any of a half-dozen AI techniques to do it, that I don't think tech is actually the bottleneck.
- eva1984 10y ago
  Well, with DL powered algorithm/device, people can pretty much practice self-diagnosis, and only under circumstances, where the model is predicting a higher risk, they can go to clinic to get the human treatment. Overall AI will ease the demand for human doctors, maybe not overnight, but gradually yet quickly. Cheaper healthcare for all, thinner salary for doctors, I will say not a bad deal overall.
sremani 10y ago
There are not that many doctors in the pipeline to meet the demands of the future. Especially, with longer lifespans and demographics spurts in places like Africa. These are good complementary tools for medical care with the doctor "quarterbacking" while all the "blocking and tackling" is automated.
supersaiyanverx 10y ago
I don't have much experience with specialists, but my experience with GPs has been awful, for every good one you meet, you have to deal with 5 other terrible ones. I will never give up my GP until he retires or an AI replaces him because he is probably the first doctor since my childhood with an actual air of competency around him. I feel bad for the rest of the people who visit my clinic and have to deal with any of the other garbage practitioners who usually fall into one of two buckets. Foreign (mainly Indian) hacks with zero medical knowledge and bedside manners, and greedy yuppie strivers with a knack for memorization but terrible analytical ability. Most doctors don't deserve their inflated salaries or social status, and I hope they are soon brought back down to Earth by technology, they have been able to skid by for way too long.
- majkinetor 10y ago
  This is exactly my experience. In some medical domains its even worse - I think I have never seen a good dentist. Can you even build up passion about staring at random human mouths ?
mhb 10y ago
Another perspective: The Heroism of Incremental Care – Atul Gawande https://news.ycombinator.com/item?id=13485354 https://news.ycombinator.com/item?id=13485354
zwieback 10y ago
I feel the exact opposite - in my treatment for prostate cancer the human interaction with doctors were a hugely positive experience for me. Interpretation of biopsies and inspection of cancer images were part of that process and I'm sure machine vision algorithms could help in this area. However, even if the classification of the cancer cells improves, the role of the doctor guiding the patient through the right treatment process still remains something I would not want to turn over to an algorithm. I have also encountered doctors I did not like but fortunately for me I had a choice where to go. Maybe machine learning should focus on weeding out unpopular practitioners instead.
- transcranial 10y ago
  I think medicine will over time morph from a field generally perceived as an intellectual one, to a largely humanistic one, like nursing. Most people, especially the HN crowd, vastly underestimate the importance of the human touch. A doctor who possesses this can make a huge difference, but sadly the are outnumbered by those who do not.
  - outlace 10y ago
    Medicine isn't really that intellectual. It's mostly based on vast amounts of acquired knowledge via rote memorization and repetitive experiences. It's not like physics or math that requires actual creativity and intellectual vigor. (I'm a 3rd yr med student)
    - monkmartinez 10y ago
      Especially as we become evidence based vs. eminence based.
  - mablap 10y ago
    The trend over the last 10 years here in Canada has been exactly that. There are now multiple tests one has to take before med school admissions, all of which are designed to weed out "bad" candidates. The desired candidate seems to be a good human who has the required stamina and intelligence to complete the curriculum. However, since there are so many applicants, schools have no choice but to cut all below a certain GPA. This has an effect on the pool of applicants and the schools are trying to mitigate that.
j8m88 10y ago
I've been harbouring similar thoughts to you for quite some time. I live in Canada, where healthcare is supposedly "free" (it's not, you get taxed like crazy here!). The treatment you receive here is subpar in my opinion. The declining quality of treatment, I'm guessing is most likely attributed to an increasing population and the limited number of quality doctors available to treat these people. I would assume these challenges aren't unique to Canada and from an outsider's perspective the medical system in the US seems worse (maybe not if you're rich)
amelius 10y ago
You should always ask your doctor for a treatment plan, i.e., a structured approach to curing your condition. Make them plan a few steps ahead. And question that plan.
eatbitseveryday 10y ago
> an algorithm can do your job better than you What I find people miss here is that computers will not help you heal your boo-boos. Say you get stabbed in the face with a knife. You need a doctor to help you. Or to give birth.
Gatsky 10y ago
Honest question: if you have had a bad experience with a healthcare system that doesn't deliver the sort of care that you want, what makes you think that some machine learning based implementation with a human spokesperson is going to be better? How will you question the results of the algorithm?
- eva1984 10y ago
  Cheaper, more cost effective for sure.
  - Gatsky 10y ago
    The OP's comment was not asking for a cheaper or more cost-effective alternative.
    - eva1984 10y ago
      It is related. When the diagnosis is much cheaper and doesn't require that much of a long wait, people will be much more tolerant towards it. And I don't why you bring up the spokesperson stuff, it doesn't need to.

doesnotexist 10y ago

Not so sure we are going to see an automation completely replace doctors. Just look at all the problems both technical as well as social in the self-driving cars arena. There lot more people are qualified to be drivers than to practice medicine. Instead, I think we'll see more powerful diagnostic tools at the disposal for physicians to use. Doctors will still play an important role in treating their patients and will be more effective because they'll have powerful tools assisting them. But to your point, will technology help patients feel more empowered in their medical encounters? Or to get more value out of their interactions with their doctors? https://www.remedymedical.com/ https://www.remedymedical.com/ seems to think their platform will do just that for primary care / telemedicine visits.

dave_sullivan 10y ago
> Doctors will still play an important role in treating their patients and will be more effective because they'll have powerful tools assisting them. I get into this argument with people a lot. I say something like, "Self driving cars will replace all the transport jobs" and the pedant says, "Well they won't replace ALL the transport jobs, so argument null and void." But no shit they won't replace ALL the transport jobs, if they replace even 30% of them, that's huge. Highest unemployment during "The Great Depression" was ~25%. I think in the case of transportation it will be more like 80% fewer transportation jobs in 10 years, something like that. With doctors and hospitals, if there were better incentives in place promoting any level of efficiency, we would have less need for doctors (and hospital staff in general). I agree that we won't see 100% automation. But a hospital finding it can do more and better work with 50% less staff? I could see that being a possibility in our near future, with the caveat that it won't happen in the US due to the regulatory environment and incentives in healthcare. Countries outside of the US might be more open to the idea of efficiency in healthcare.
- doesnotexist 10y ago
  Thought experiment: do you think some part of your job will be automated before or after hospitals automate away 50% of their medical staff?
  - dave_sullivan 10y ago
    Depends on which job: Programming, machine learning: it's constantly being automated, which leads to paradigm shifts. Those new paradigms are then studied, understood, and automated. Automation is about "not doing the same thing over and over again so you can solve new problems." Programming, games: I'm giving a talk later this month about automating game production with machine learning. You can't really use machine learning to be "creative" yet, but you can use it to generate novel game assets, which is actually where most of the time is spent in game dev. There's also a lot of pipeline improvements that could be made by existing tools companies, most notably Adobe and Autodesk. So the upshot is it will be possible for small teams to create much more expansive game worlds. Make GTA V for $1M instead of $260M kind of thing. But even then, the history of game design has been automating different pieces -- it's basically the reason for the existence of game engines. Starting businesses: This is controversial, but I think entrepreneurship is the highest intellectual endeavor. It requires you to apply everything you've learned about life, the universe, and everything in ways that most people haven't thought of. I think you'd need a very real AGI to do this; although I suppose I could see an algo running P&G or J&J and making decisions about what brands to invest in and divest from, along with how to market based on what people are saying on social media, stuff like that.
- whyileft 10y ago
  It is no different than going to the urgent care clinic for a strep test. Doctors do not perform those either. Most diagnosis will be done via software administered by lower paid and more easily replaceable low skill labor just like urgent care clinics do with lab testing. There are fewer accountants today because of tax software and Excel spreadsheets. They are still needed for more complex and unique situations, but there will be a lot fewer of them. The local H&R Block uses lower paid "Tax Preparers" instead. There are a lot of research done about Walmart and about when the store moved into town there were not fewer jobs, but somehow the area got poorer. What they found was that the local community leaders(small business owners, lawyers, accountants) were automated away and/or moved to Walmart headquarters. http://aese.psu.edu/nercrd/economic-development/for-researchers/poverty-issues/big-boxes/wal-mart-and-poverty/article-wal-mart-and-county-wide-poverty http://aese.psu.edu/nercrd/economic-development/for-research... Is one I could find, but that also references other papers in the field. This leads to me understand that like Walmart, the simple human physical labor jobs will remain long after the more skilled positions. The main reason, I believe, is that software is simply cheaper than hardware(robots) so highly skilled positions which require software not hardware to remove will be the first to go. This is exacerbated by the fact that the software replaceable jobs are the highest paid and therefore the most profitable to remove.
bluGill 10y ago
I think it will be both. They will start with software for doctors - who will use it because the computer never forgets to ask some critical question that could discover a 1 in a million disease and not the common cold (with similar symptoms) that the everyone else in the office today has. Eventually urgent cares and ER will install them for people directly. No reason the machine can't prescribe antibiotics for the latest form of strep that is going around. That leaves the doctor for the hard cases where the machine doesn't know.

komali2 10y ago

I never thought doctors would be hit so soon by the automation/AI crisis, but this article challenges that thought. However, due to the state of robotics at the moment, surgeons for example aren't going anywhere for a good decade I'd estimate, and it's not like people can, in the mole example, self-remove a chunk of it for biopsy with 99% accuracy. Then there's treatment that has to be done at a hospital under monitor of professionals, etc.

_delirium 10y ago
> I never thought doctors would be hit so soon by the automation/AI crisis I think most people in AI are more surprised that it took this long. The tech has been there for decades for a pretty large percentage of routine diagnostics, especially carefully defined clinical-sample type diagnostics. People were pretty sure in the '80s that it'd all be automated soon, but it never managed to make it into actual hospitals so funding dried up. Mixture of bureaucracy, legal issues, patients not liking the idea of computer diagnosis, doctors not liking the idea of computer diagnosis, incentives, etc. I think changes in all those "environmental" factors are likely to be the biggest boost to something like this getting deployed in practice. Tech advances are good as well, and will expand the range of diagnostics that can be automated, but there is already enough low-hanging fruit in medicine that is easy enough for any of a half-dozen AI techniques to do it, that I don't think tech is actually the bottleneck.
eva1984 10y ago
Well, with DL powered algorithm/device, people can pretty much practice self-diagnosis, and only under circumstances, where the model is predicting a higher risk, they can go to clinic to get the human treatment. Overall AI will ease the demand for human doctors, maybe not overnight, but gradually yet quickly. Cheaper healthcare for all, thinner salary for doctors, I will say not a bad deal overall.

sremani 10y ago

There are not that many doctors in the pipeline to meet the demands of the future. Especially, with longer lifespans and demographics spurts in places like Africa. These are good complementary tools for medical care with the doctor "quarterbacking" while all the "blocking and tackling" is automated.

supersaiyanverx 10y ago

I don't have much experience with specialists, but my experience with GPs has been awful, for every good one you meet, you have to deal with 5 other terrible ones. I will never give up my GP until he retires or an AI replaces him because he is probably the first doctor since my childhood with an actual air of competency around him. I feel bad for the rest of the people who visit my clinic and have to deal with any of the other garbage practitioners who usually fall into one of two buckets. Foreign (mainly Indian) hacks with zero medical knowledge and bedside manners, and greedy yuppie strivers with a knack for memorization but terrible analytical ability. Most doctors don't deserve their inflated salaries or social status, and I hope they are soon brought back down to Earth by technology, they have been able to skid by for way too long.

majkinetor 10y ago
This is exactly my experience. In some medical domains its even worse - I think I have never seen a good dentist. Can you even build up passion about staring at random human mouths ?

mhb 10y ago

Another perspective: The Heroism of Incremental Care – Atul Gawande https://news.ycombinator.com/item?id=13485354 https://news.ycombinator.com/item?id=13485354

zwieback 10y ago

I feel the exact opposite - in my treatment for prostate cancer the human interaction with doctors were a hugely positive experience for me. Interpretation of biopsies and inspection of cancer images were part of that process and I'm sure machine vision algorithms could help in this area. However, even if the classification of the cancer cells improves, the role of the doctor guiding the patient through the right treatment process still remains something I would not want to turn over to an algorithm. I have also encountered doctors I did not like but fortunately for me I had a choice where to go. Maybe machine learning should focus on weeding out unpopular practitioners instead.

transcranial 10y ago
I think medicine will over time morph from a field generally perceived as an intellectual one, to a largely humanistic one, like nursing. Most people, especially the HN crowd, vastly underestimate the importance of the human touch. A doctor who possesses this can make a huge difference, but sadly the are outnumbered by those who do not.
- outlace 10y ago
  Medicine isn't really that intellectual. It's mostly based on vast amounts of acquired knowledge via rote memorization and repetitive experiences. It's not like physics or math that requires actual creativity and intellectual vigor. (I'm a 3rd yr med student)
  - monkmartinez 10y ago
    Especially as we become evidence based vs. eminence based.
- mablap 10y ago
  The trend over the last 10 years here in Canada has been exactly that. There are now multiple tests one has to take before med school admissions, all of which are designed to weed out "bad" candidates. The desired candidate seems to be a good human who has the required stamina and intelligence to complete the curriculum. However, since there are so many applicants, schools have no choice but to cut all below a certain GPA. This has an effect on the pool of applicants and the schools are trying to mitigate that.

j8m88 10y ago

I've been harbouring similar thoughts to you for quite some time. I live in Canada, where healthcare is supposedly "free" (it's not, you get taxed like crazy here!). The treatment you receive here is subpar in my opinion. The declining quality of treatment, I'm guessing is most likely attributed to an increasing population and the limited number of quality doctors available to treat these people. I would assume these challenges aren't unique to Canada and from an outsider's perspective the medical system in the US seems worse (maybe not if you're rich)

amelius 10y ago

You should always ask your doctor for a treatment plan, i.e., a structured approach to curing your condition. Make them plan a few steps ahead. And question that plan.

eatbitseveryday 10y ago

> an algorithm can do your job better than you What I find people miss here is that computers will not help you heal your boo-boos. Say you get stabbed in the face with a knife. You need a doctor to help you. Or to give birth.

Gatsky 10y ago

Honest question: if you have had a bad experience with a healthcare system that doesn't deliver the sort of care that you want, what makes you think that some machine learning based implementation with a human spokesperson is going to be better? How will you question the results of the algorithm?

eva1984 10y ago
Cheaper, more cost effective for sure.
- Gatsky 10y ago
  The OP's comment was not asking for a cheaper or more cost-effective alternative.
  - eva1984 10y ago
    It is related. When the diagnosis is much cheaper and doesn't require that much of a long wait, people will be much more tolerant towards it. And I don't why you bring up the spokesperson stuff, it doesn't need to.